Review Question - QID 214974

A 45-year-old woman presents to the ambulatory clinic with 2 days of painful mouth sores. She has experienced several loose, watery stools and increasing fatigue over the past week. Her joints feel achy but she attributes these to her recent diagnosis of rheumatoid arthritis. She denies fevers, chills, or abdominal pain. Her other medical history includes recurrent cold sores (herpes labialis), diabetes, and hypothyroidism. Her medications include insulin, levothyroxine, and methotrexate. She has multiple sexual partners and does not use protection. The patient’s temperature is 98.8°F (37.1°C), blood pressure is 124/74 mmHg, pulse is 74/min, and respirations are 16/min. Physical exam reveals a tired-appearing woman with several round ulcers inside her oral cavity. There is no skin rash. Her laboratory results are as follows:

Hemoglobin: 9.1 g/dL
Hematocrit: 27.3%
Leukocyte count: 7,500/mm^3
Platelet count: 300,000/mm^3
Mean corpuscular volume (MCV): 112 µm^3

What is the most appropriate treatment for this patient's current condition?